Browsing by Author "Cortez-Pinto, H."
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- Hepatic steatosis in an adult population: stronger correlation with the presence of obesity and insulin resistence than with the dietary pattern: results from a cross-sectional studyPublication . Leitao, J.A.M.C.P.; Cochicho, J.; Carvalhana, S.; Velasco, F.; Silva, A.P.; Medeiros, I.S.; Alves, A.C.; Bourbon, M.; Oliveiros, B.; Rodrigues, V.; Carvalho, A.; Cortez-Pinto, H.Background and Aims: Hepatic steatosis is very frequent in thegeneral population, mostly associated with obesity and insulinresistance. Typical dietary patterns have been difficult to identifywith controversial information. We aimed to estimate in a represen-tative sample of the Portuguese adult population, what was thecontribution of the dietary pattern in what concerns macronutrientsand food groups for the presence of steatosis as well as the othertraditional risk factors for steatosis.
- Hepatitis B and C prevalence in Portugal: disparity between the general population and high-risk groupsPublication . Carvalhana, S.C.; Leitão, J.; Alves, A.C.; Bourbon, M.; Cortez-Pinto, H.Background and aims: The prevalence of anti-HCV and HBsAg in Portugal has been shown to be elevated in high-risk groups, such as intravenous drug-users and incarcerated individuals. However, in the general population, prevalence remains largely unknown. The aims of this study were to estimate the prevalence of anti-HCV and HBsAg in the general Portuguese population and identify associated risk factors. Materials and methods: We carried out a nationwide, population-based cross-sectional study of adults resident in mainland Portugal. Serology for HBsAg, anti-HBc, anti-HBs, and anti-HCV was performed. Anti-HCV-positive individuals were tested for HCV RNA by PCR. Results: Of 1685 participants, 50.6% were men, mean age 50.2±18.3 years. In terms of hepatitis C, the prevalence of anti-HCV was 0.54% [95% confidence interval (CI): 0.2–0.9] and 0.12% (95% CI: 0.0–0.3) were viremic, with peak prevalence among individuals 35–64 years of age (0.8%), men (0.8%), and individuals from Lisbon and Tagus Valley region (1.9%). In terms of hepatitis B, the estimated prevalence of HBsAg was 1.45% (95% CI: 0.9–2.0). A higher prevalence was found in individuals who were 35–64 years old (2.2%), in men (2.5%), and in the Northern region (2.6%). The presence of positive serological markers of hepatitis C virus and hepatitis B virus infection did not correlate with elevated aminotransferases, race, place of birth, and alcohol consumption. Conclusion: These results suggest a low endemicity for both hepatitis B and hepatitis C in the general population, in contrast to a very high prevalence in risk groups, thus suggesting that targeted screening to high-risk groups may be more cost-effective than general population screening.
- How good is controlled attenuation parameter and fatty liver index for assessing liver steatosis in general population: correlation with ultrasoundPublication . Carvalhana, S.; Leitão, J .; Alves, A.C.; Bourbon, M.; Cortez-Pinto, H.Liver steatosis measurement by controlled attenuation parameter (CAP) is a non-invasive method for diagnosing steatosis, based on transient elastography. Its usefulness as screening procedure for hepatic steatosis in general population has not been previously evaluated. The aim of this study was to evaluate the diagnostic accuracy of CAP and fatty liver index (FLI) for detection and quantification of steatosis in general population.
- Lysosomal acid lipase deficiency: a hidden disease among cohorts of familial hypercholesterolemia?Publication . Chora, J.R.; Alves, A.C.; Medeiros, A.M.; Mariano, C.; Lobarinhas, G.; Guerra, A.; Mansilha, H.; Cortez-Pinto, H.; Bourbon, M.Highlights: - Dyslipidemia phenotype of patients with familial hypercholesterolemia and lysosomal acid lipase deficiency (LALD) can overlap; - Familial hypercholesterolemia negative patients should be investigated to identify possible LALD patients; - Correct identification of LALD patients is important for patient prognosis. Background: Lysosomal acid lipase deficiency (LALD) is an autosomal recessive disorder and an unrecognized cause of dyslipidemia. Patients usually present with dyslipidemia and altered liver function and mutations in LIPA gene are the underlying cause of LALD. Objective: The aim of this study was to investigate LALD in individuals with severe dyslipidemia and/or liver steatosis. Methods: Coding, splice regions, and promoter region of LIPA were sequenced by Sanger sequencing in a cohort of mutation-negative familial hypercholesterolemia (FH) patients (n = 492) and in a population sample comprising individuals with several types of dyslipidemia and/or liver steatosis (n = 258). Results: This study led to the identification of LALD in 4 children referred to the Portuguese FH Study, all with a clinical diagnosis of FH. Mild liver dysfunction was present at the age of FH diagnosis; however, a diagnosis of LALD was not considered. No adults at the time of referral have been identified with LALD. Conclusion: LALD is a life-threatening disorder, and early identification is crucial for the implementation of specific treatment to avoid premature mortality. FH cohorts should be investigated to identify possible LALD patients, who will need appropriate treatment. These results highlight the importance of correctly identifying the etiology of the dyslipidemia.
- Prevalence of alcoholic steatosis in the general adult Portuguese populationPublication . Leitao, J.A.M.C.P.; Carvalhana, S.; Cochicho, J.; Silva, A.P.; Velasco, F.; Medeiros, I.S.; Alves, A.C.; Bourbon, M.; Oliveiros, B.; Rodrigues, V.; Carvalho, A.; Cortez-Pinto, H.Background and Aims: Fatty liver is very frequent in the general population. Although many studies evaluated the prevalence of nonalcoholic fatty liver disease there is scarce information regarding alcoholic fatty liver. We aimed to estimate the prevalence of alcoholic hepatic steatosis, and to what extent it depended on obesity and its interaction.
- What is the role of the new index relative fat mass (RFM) in the assessment of nonalcoholic fatty liver disease (NAFLD)?Publication . Machado, M.V.; Policarpo, S.; Coutinho, J.; Carvalhana, S.; Leitão, J.; Carvalho, A.; Silva, A.P.; Velasco, F.; Medeiros, I.; Alves, A.C.; Bourbon, M.; Cortez-Pinto, H.Introduction: Nonalcoholic fatty liver disease (NAFLD) is the liver manifestation of adiposopathy. Recently, a new score was developed to estimate body fat percentage (relative fat mass, RFM). We aimed to evaluate the value of RFM in predicting the presence and severity of NAFLD, compared with other anthropometric measurements. Methods: RFM, body mass index (BMI), and other anthropometric measurements were evaluated in two cohorts of subjects: a cohort from a Portuguese prospective epidemiological study (e_Cor) and morbidly obese patients with biopsy-proven NAFLD. We evaluated if RFM and BMI were related with the presence and severity of liver disease, which was assessed by noninvasive tools in the first cohort and by liver histology in the morbidly obese cohort. The independence of relations found in univariate analysis was assessed with multivariable logistic regression analysis. Results: In the general population cohort, 744 subjects (48% male) were enrolled. BMI-defined obesity was present in 23% and RFM-defined obesity in 86%. Insulin resistance (IR) related with BMI-defined obesity (OR 4.37 [2.16-8.84]) and weight (OR 1.05 [1.02-1.08]) in men, and waist circumference (WC) (OR 1.07 [1.03-1.11]) in women. Dyslipidemia and hypertension related with RFM-defined obesity in men (OR 2.96 [1.36-6.47] and OR 5.37 [1.31-22.06], respectively). Ultrasound-diagnosed NAFLD in 33% related with weight in men (OR 1.03 [1.003-1.06] and WC in women (OR 1.06 [1.02-1.10]). In men, ALT elevation related with weight (OR 1.04 [1.02-1.07]). In women, advanced fibrosis (estimated by NAFLD Fibrosis Score) associated with BMI-defined obesity (OR 42.43 [3.61-498.13]). In the morbidly obese cohort, 152 subjects were enrolled, of whom 84% were female, 37% had steatohepatitis, and 9.4% had advanced fibrosis. Adiponectin associated inversely and leptin positively with RFM in men. The severity of steatosis increased linearly with BMI and WC in women. Higher BMI associated with steatohepatitis in women and advanced fibrosis in men. Conclusion: RFM-defined obesity better predicted dyslipidemia and hypertension (though not IR) and adipokine imbalance; however, it did not add value to BMI-defined obesity in predicting NAFLD or liver injury.